Pocket of air found where man's brain should've been

As explained in a case report called "The man that lost (part of) his mind" in the journal BMJ Case Reports, the 84-year-old man turned up to the emergency room at Causeway Hospital in Northern Ireland after suffering from a weakness on the left side of his body and repeatedly falling over. Other than the weakness, which lasted for three days, medical staff noted that he didn't have any confusion, facial weakness, vision or speech problems, and was otherwise reportedly feeling fine.

Perhaps nothing too odd for a man of his age, but further investigations revealed these symptoms were a red flag signaling much bigger problems.

Staff made a decision to give the man a CT and MRI scan, and it was then that they saw the blank where some of his brain should have been, measuring 3.5 inches long. He didn't smoke. He rarely drank.

"(We) were all very perplexed by the images we saw!" Usually, such air pockets are seen-on a smaller scale-in those who have undergone brain surgery.

But as with any surgery, there would be some risks for the patient.

Dr. Finlay Brown, one of the physicians involved in the Irish man's case, declared that this is, by far, the largest formation of this kind ever to be recorded.

"To find a pocket of this size in an organized fashion was extremely uncommon, with very few documented cases found while I was researching for writing up the case report", Brown added.

An MRI scan also revealed an osteoma, or benign bone tumor, in a part of the skull that separates the brain from the nasal cavity, called the ethmoid bone.

"From speaking to the specialists, it seems it has been progressing insidiously over months to years", Brown said. He was given medication to prevent a secondary stroke and sent home with orders to monitor whether his left-side weakness worsened. For example, decompressing the brain area could have led to more problems, and the surgery might not have helped the patient's symptoms, Brown said.

Although the scan appeared to show part of his brain was missing, it later transpired the doctors were looking at a massive air-filled cavity, what's known as a pneumatocoele.

The patient declined surgery due to the risks it presented, and the case report stated, "the left-sided weakness was noted to have resolved on follow-up 12 weeks later and he remained well".

Brown told LiveScience he wanted to publish this case study to stress "the importance of thorough investigation of even the most common of symptoms", as an octogenarian's frequent falls and imbalance could have easily been written off. "Because every now and then, there will be a rare [or] unknown causation of these that could be overlooked", he said.

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